Chloroquine toxicity of retina

While many of these can be grouped by anatomic location or type of toxicity, there are also individual medications with characteristic effects. In this article, we will describe several major categories of pharmacologic retinaltoxicity and discuss examples of individual medications.

Retina Manifestations of Chloroquine and Hydroxychloroquine Toxicity. The classical definition of chloroquinetoxicity is characterized by bilateral pigmentary change of the macula usually sparing the fovea. This has come to be known as bull’s-eye maculopathy. The retinal periphery may also be involved but infrequently. Chloroquine is quinolone derivative known to exert dose‐related retinaltoxicity, albeit in a variable manner. It is thought that variability in the presentation of chloroquine retinopathy may be the result of perturbations in drug bioavailability subsequent to oral ingestion. Retinaltoxicity has been shown in patients taking greater than 3 mg/kg/day of chloroquine or 6.5 mg/kg/day of hydroxychloroquine. While most cases of toxicity have been reported for chloroquine, hydroxychloroquine has supplanted it as the more commonly used treatment agent for both RA and SLE. 2

Both medications have been shown to bind melanin and to concentrate in the iris, ciliary body and retinal pigment epithelium, altering normal physiologic function. Chloroquine (Aralen) and hydroxychloroquine (Plaquenil) are traditional antimalarial agents now used in the treatment of autoimmune diseases, including rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE).

Chloroquineretinaltoxicity. Contributor Jesse Vislisel, MD. Photographer Toni Venckus, CRA. Retinaltoxicity from chloroquine is now rare in the U. S. as the medication has been largely replaced by hydroxychloroquine. These photographs show the toxic effects of chloroqine after taking a dose of 500mg daily for 5 years.

Chloroquineretinaltoxicity The University of Iowa..

Common Medications That May Be Toxic to the Retina.

Chloroquine Retinopathy - an overview ScienceDirect Topics.

Interactions Chloroquinetoxicity may be increased by all drugs with quinidine-like effects. Combination with hepatotoxic or dermatitis-causing medication should be avoided, as well as with heparin risk of hemorrhage and penicillamine. Eye Keratopathy and retinopathy may occur when large doses of chloroquine are used for long periods. Hydroxychloroquine toxicity Disease Entity. Hydroxychloroquine Plaquenil and chloroquine cause ocular toxicity. Diagnosis. For retinopathy, patients should be asked about poor central vision. Management. At the first signs of retinaltoxicity, hydroxychloroquine should be stopped. Chloroquine and hydroxychloroquine retinopathy rare if recommended dose limits followed ; Once visual symptoms develop, they cannot be reversed, and may worsen even if medication stopped; Monitoring with visual fields, optical coherence tomography, and electroretinography allows earlier detection of toxicity and may prevent disabling vision loss

A 45-year-old black female presented with no ocular or visual complaints. However, her medical history was significant for a recent diagnosis of lupus. Retinal Physician - Hydroxychloroquine Maculopathy An. Hydroxychloroquine An old drug with new relevance Cleveland Clinic. Hydroxychloroquine toxicity - EyeWiki

Hydroxychloroquine is a quinoline medicine used to treat or prevent malaria, a disease caused by parasites that enter the body through the bite of a mosquito. Hydroxychloroquine is also an antirheumatic medicine and is used to treat symptoms of rheumatoid arthritis and discoid or systemic lupus erythematosus.

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Sensitivity to UV light during treatment with chloroquine in. Provocation with high dose UVA and UVB was similar with and without treatment with chloroquine or hydroxychloroquine. Our results have shown that photosensitivity during medication with chloroquine and hydroxychloroquine is uncommon and that there is no need to stop this treatment due to sun exposure. PMID 1439633 Indexed for MEDLINE MeSH terms